Autologous Transplant Guide: Blood Counts & Transfusions
Waiting for engraftment
高剂量的化疗或放疗会导致骨髓停止产生新的血细胞. 新骨髓在移植后不会立即恢复. The cells of the transplanted marrow will travel to the bones, 重新播种骨髓空间,在成熟细胞从骨髓释放到血液之前经历一个生长过程. 从移植那天起,你的血液计数开始恢复至少需要8到14天.
“血细胞计数”指的是血液中循环的血细胞数量. 血细胞主要有三种:红细胞、白细胞和血小板. 当骨髓仍在生长时,这些细胞将需要通过输血来替换.
Engraftment 这个术语是用来描述你的新骨髓何时开始发挥作用并产生细胞吗. 在等待移植的过程中,没有成熟细胞离开骨髓进入血液. 你的血球计数将显示非常低的数值,你将需要由健康护理小组仔细监测. 目的是通过红细胞和血小板输注来支持你,直到你再次产生细胞.
After transplantation, you will receive a bone marrow growth factor, called G-CSF, which will help the cells of the bone marrow grow and mature. The growth factor is given as an injection under the skin daily.
Types of blood cells
White blood cells (WBCs)
White blood cells fight infection. They include neutrophils and lymphocytes, among others.
Neutrophils白细胞,也被称为多细胞或粒细胞,占循环白细胞的大部分. 它们主要负责对抗细菌和真菌感染. 骨髓生长因子如G-CSF(也称为neupogen)使中性粒细胞计数上升. 中性粒细胞计数应至少为500(通常实验室检测结果报告为0).5) by 30 days after transplantation.
Neutrophils are not usually transfused except in special circumstances. 使用抗生素对抗感染和生长因子帮助骨髓生长通常是足够的,直到中性粒细胞计数上升.
Lymphocytes are the backbone of the immune system. 这些细胞负责对抗病毒,并形成抗体,攻击传染性生物体. 淋巴细胞功能通常在移植后3个月内出现异常. 这意味着即使白细胞计数正常,你也可能会出现严重的感染.
Red blood cells (RBCs)
RBCs carry oxygen throughout the body. The hematocrit means the percentage of blood that contains red cells. The hemoglobin is the part of the red blood cell that carries oxygen. The hemoglobin is proportional to the hematocrit.
Anemia occurs when there are not enough red blood cells in the body. 症状包括呼吸短促、虚弱、疲劳、头晕、头痛和易怒. 红细胞输注通过导管平均需要两到三个小时. Additional transfusions may be needed as an outpatient, or you may be given erythropoietin (Epo), a red blood cell growth factor.
Platelets
Platelets help control bleeding. 当你割伤自己时,血小板会形成凝块或堵塞来止血. 血小板计数低的一些症状包括斑点(皮肤上的小红点), easy bruising, and bleeding from the gums or nose.
Platelet transfusions
当血小板计数过低而不能防止严重的组织出血时,常规地进行血小板输注. 化疗开始一周后,你将开始需要输血小板. 每周需要输血的次数因患者而异,从每周1次到7次不等.
You will continue to need platelet transfusions for three to six weeks, sometimes longer, 这取决于你的骨髓恢复情况或者你正在接受什么药物治疗.
There are two types of platelet transfusions:
Single donor platelet transfusions
这些技术使用的血小板是从一个人身上采集的,这一过程被称为单采, which takes about two to two-and-a-half hours. In this procedure, 血液从献血者身上取出,通过一种叫做血细胞分离器的机器循环. 这台机器将血小板分离到一个收集袋中,并将剩余的血液成分返回给献血者.
大多数单一供体血小板来自患者的家人和朋友. Your platelet donors do not need to have your blood type. 如果有更合适的单一供体,您将无法从指定的供体获得血小板.
Random donor platelet transfusions
这些使用的血小板是从几个不同的随机献血者捐献的几个单位的全血中汇集而成的. These are the most common type of platelets to be transfused.
潜在的血小板捐献者必须在捐献前通过初步测试, which involves a written history form, checking vital signs and taking a small blood sample. 所有献血者都经过仔细的传染病筛查,以确保他们的血液安全.
Reactions to blood transfusions
你有时可能会对你的血液制品输血有不舒服的反应. 其中一些反应可能包括发烧、发冷、颤抖、瘙痒和皮疹. Infrequent side effects are back pain and shortness of breath. 如果你有副作用,药物可以限制反应.
The red blood cells and platelets are irradiated and filtered, 通常在输血前可以使用药物来减少副作用. Your nurse will watch carefully for any of these reactions, and you should also report any symptoms to your nurse.
Donating blood products
如果你安排家人献血供你住院期间使用,这是有帮助的. 只要完成血库筛选程序并通过所有测试,任何人都可以成为献血者.
Donations can be given at any donor center; however only donations given at Blood Banks of the Pacific in San Francisco will be available for you during your hospitalization.
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